CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Kaleida Health

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $314
Cash Discount Price: $907
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Kaleida Health is $314. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $907. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.29x the Medicare baseline. Located in 100 High Street, Buffalo, NY.

Cash / Self-Pay

$907

Average discount available for prompt cash payment at this facility.

Insurance Median

$314

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $907 (372%)

Insurance Median: $314 (129%)

Cash: $907 (372% of Medicare)

Ins. Median: $314 (129% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Fidelis Care	$62 - $65	25%
UnitedHealthcare	$63 - $323	26%
Highmark Wny	$66 - $86	27%
Univera Healthcare	$109 - $115	45%
Ghi/Emblem Health	$137 - $402	56%
Ghi/Emblem Health - Wchob	$137 - $172	56%
Aetna	$143 - $316	59%
Magnacare	$143 - $183	59%
Magnacare - Wchob	$143 - $183	59%
Independent Health Association	$173 - $554	71%
Independent Health Association - Wchob	$180 - $554	74%
Blue Cross Blue Shield	$203 - $1,111	83%
Tricare	$283	116%
Univera	$292 - $1,250	120%
Wellcare	$310	127%
Fidelis	$322	132%
Cigna	$348 - $423	143%
Univera - Wchob	$404 - $1,250	166%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $907.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72148.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kaleida Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72148.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.